Individual
ALBERT MARK WEISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
11092 ANDERSON STREET, LLU SCHOOL OF DENTISTRY, LOMA LINDA, CA 92350-0001
(909) 558-4613
(909) 558-4192
Mailing address
11092 ANDERSON STREET, LLU SCHOOL OF DENTISTRY, LOMA LINDA, CA 92350-0001
(909) 558-4613
(909) 558-4192
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
18947
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18947
STATE LICENSE
CA
Enumeration date
08/29/2008
Last updated
08/29/2008
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